Nutrition, Weight Loss, and Physical Therapy

Plant-Based Diet: Weight Loss and Arthritis Hope?

By Dr. Sean Wells, DPT, PT, OCS, ATC/L, CSCS, NSCA-CPT, CNPT, Cert-DN

A recent study published in Obesity Science and Practice shows promise for those wanting to lose weight, improve their metabolic status, and possibly reduce arthritis symptoms: all with dietary changes. The researchers examined 244 overweight individuals for 16 weeks. The participants were randomly assigned to either a low fat plant-based diet or a control group that made no dietary changes. Both groups looked identical at the beginning of the study with similar body composition measures, insulin metrics, and self-reported advanced-glycation end-products consumption (AGEs). 

After the 16 week intervention, the subjects in the plant-based group noted a significant reduction in body mass of 14 lbs compared to the 1 lb weight loss in the control group. Researchers noted that the plant-based group saw a significant reduction in fat mass, notably visceral fat. Another major finding from the study was that AGEs were reduced by 79% in the plant-based group, while they only went down 15% in the control group.

This study is significant to patients in that several physical therapy clinical practice guidelines (CPGs) ask physical therapists (PTs) to discuss weight loss to improve several common conditions. One such condition would be hip arthritis (OA), which patients commonly present with hip pain and obesity. Obesity increases systemic inflammation due to metabolic factors and inflammatory compounds released by fat cells. Moreover, obesity does increase and alters the loading of the hips and other joints, which may also contribute further to arthritis. Reducing body fat, as seen in this specific study using a plant-based diet, would significantly help patients with hip OA. Despite all of these benefits and guidelines, many traditional insurance-based physical therapist never breach the subject of weight loss or nutrition. Our practice is different and our Wells Physical Therapy team can help you lose weight.

Another finding from this study was that patients in the plant based group reduced their consumption of certain aging and arthritis-promoting compounds called AGEs. When people eat foods high in AGEs they can see their arthritis flare, noting significant increases in joint pain, inflammation, and stiffness. AGEs are linked with interrupting joint collagen synthesis, inflammation, and metabolic dysfunction. These compounds are formed during cooking, typically with meat over high heat and with sugar (think barbeque ribs as the worse). Reducing foods, particularly meat, that contribute to AGE intake will further help reduce inflammation and pain for patients with arthritis. A plant-based diet, which predominantly focuses on reducing animal products and processed foods, would be an ideal diet to reduce AGEs in our PT patients. Our PTs can help guide you to foods that will help you reduce pain, inflammation, and overall health.

Interestingly the findings from this study seem amazing but are not surprising to me and the PTs that work with me. For years we have seen the positive benefits of a plant-based diet for our patients with arthritic, cardiac, and diabetic conditions. We have seen patients lose weight, get stronger with our exercises, and reduce their joint pain and inflammation.

Call us today and schedule an evaluation with one of our skilled Doctors of Physical Therapy: 904-568-1156

Disclaimer: The above article is written as an opinion piece and does not convey specific legal, medical, and/or practice act advice. 

3 Tips for Home Physical Therapy During COVID-19

Changes

The Corona virus (COVID-19) has effectively shut down many businesses. Bars, movie theaters, and even many physical therapy operations have shut their doors. Physical therapy often requires manual work, close contact for cuing during exercises, and close eyes to spot for problems and other issues. COVID-19 may have limited some of these capabilities of your local physical therapists, but there’s hope if you are struggling with some recent back pain or joint problem. Below we are going to offer 3 tips on how you can effectively manage your pain and issues from home with physical therapy and exercise.

Tip #1: Call or message your local PT

If you have a standing relationship with a local PT in Naples or St. Augustine, call them and ask them to help you. Many PTs have transitioned to tele-health and virtual consultations. A phone conversation can help the PT create a history and offer a chance to screen for other major medical issues. A virtual consult can provide the PT a “visual” of how you are moving and what your condition looks like. Moreover, a virtual session can offer a PT a chance to implement exercises, which a PT can correct thanks to the visual feedback. If you are needing manual therapy such as massage, joint mobilizations, or manipulations, a PT can also guide you through your own techniques to reduce your pain with your own hands. It may not be the same as how your PT does it but it is better than not getting the skilled advice at all. When going this route expect for the PT to still bill your insurance or ask for cash payment (depending on the practice). Also, be aware that sessions are usually capped at around half an hour, so don’t expect long calls or virtual meetings.

Tip #2: Pick up your home exercise program, again!

Did you already have that achy knee or low back pain several months ago? The best advice most PTs will offer you is to restart your home exercise program (HEP). Many patients will often backslide or regress when they stop doing their exercises, so ultimately the most logical step would be to start exercising again! Dust-off that HEP and get moving. Start basic and focus on movements that are pain-free. Simple walking, basic strength movements with body weight, and light stretching can often be the home-based cure for many PT ailments! This is likely rare, but worth stating: if you are in severe pain or have markedly limit motion, call your PT first before starting your program again.

Tip #3: Progress your home program

Were you on a treatment plan after your total knee replacement or back surgery but had to stop going to therapy because of the Corona virus? You likely have been doing your HEP religiously but have been feeling “stuck” or noticing some of the pain coming back. Your best bet is to progress your routine slightly. One easy way to progress is to add a few more repetitions to an existing movement. If you’ve been doing 10 squats, progress to 15; push 15 band rows to 20 rows. Another method is to increase your weight with a movement: increase your upper body weight by 2-5 lbs or lower body weights by 5-10 lbs. This can be tough at home if you don’t have weights but don’t stress. Most people have soup cans, detergent, gallon jugs of water or milk, and suitcases. Here’s a sample of what these weigh:

1. 16 oz soup can = 1 lb

2. 2 liter of soda = ~4 lb

3. Gallon of water = 8 lb

4. 150 oz of detergent = 10 lbs

You can use the suitcase to load items in it for more weight or to better customize to your needs. Adding weight takes some creativity but can be fun. Lastly, adding more exercises can also help you progress your routine. Many of our patients have been using Nike Training Club app ,HEP2Go, and similar programs to get useful ideas for new movements. Recall the movements should be pain free, fun, but challenging. Ultimately if you aren’t certain about adding exercises or are having severe pain or problems, call your PT!

Be safe, stay moving, and eat well!

Drs. Wells, Lauzon, and Otto

Image source: Marco Verch, no changes made, CC BY 2.0.

Keywords: physical therapy, home, naples, st augustine, ponte vedra

New Health Model for PTs: Wellness and Prevention

Insurance physical therapy at your hospital or local clinic is steeped in tradition: find the one problem, focus on it, and fix it. The services are reimbursed based on a fee-for-service model. The more care the more payment that is given, regardless of outcomes or future setbacks. Physical therapist's (PT) education skews also towards the model of problem-based learning, exam, and intervention. Lost in the mix of the insurance and educational maelstrom is the patient: what other issues are lurking, how do they address the "whole" patient and not just the one body part or pain, and how can they continue living healthy and happy?

Fortunately a new model of PT practice emerged. The Health-Focused Therapy Model (HFPTM) promotes PTs to recommend notions like smoking cessation, regular physical activity, and even nutrition, when/where appropriate. Researchers at the University of Alabama at Birmingham produced the new model which hopes to only enhance what PTs currently offer.

Your Doctors of Physical Therapy at Wells PT embrace, endorse, and put into practice the Health-Focused Therapy Model of care. From smoking cessation, exercise interventions, physical activity promotion, and nutritional counseling, Dr. Wells and Lauzon want the best for the whole YOU -- not just your knee or shoulder. Use the Contact tab on our webpage to set up your consultation today for the best Physical Therapy you've ever had.